CMS Price Transparency Data

Bunion correction surgery

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 28296 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 28296
Insurance Median: $304
Cash Discount Price: $2,960
vs. Medicare Baseline: 0.09x Medicare

The contracted insurance negotiated median rate for a Bunion correction surgery at Samuel Mahelona Memorial Hospital is $304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,960. Compared to the federal Medicare reimbursement reference rate of $3,342.87, this hospital’s rate is 0.09x the Medicare baseline. Located in 4800 Kawaihau Road, Kapaa, HI.

Cash / Self-Pay

$2,960

Average discount available for prompt cash payment at this facility.

Insurance Median

$304

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3,342.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3,342.87 (100%)

Cash / Self-Pay: $2,960 (89%)

Insurance Median: $304 (9%)

Cash: $2,960 (89% of Medicare)

Ins. Median: $304 (9% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3,342.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$181 - $434	5%
Kaiser Permanente	$181 - $598	5%
Hawaii Medical Service Association	$181 - $817	5%
Ohana Health Plan	$499 - $538	15%
Alohacare	$499 - $538	15%
Devoted Health	$548	16%
University Health Alliance	$672	20%
Hawaii Western Management Group	$700	21%
Health Management Network	$3,871	116%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,960.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 28296.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Samuel Mahelona Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 28296.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.